Posted
by
timothy
on Thursday February 12, 2009 @02:00PM
from the thanks-court dept.

wiredog writes "From The Washington Post comes word that three special masters have decided that MMR vaccines do not cause autism. 'Special master George Hastings said the parents ... had "been misled by physicians who are guilty, in my view, of gross medical misjudgment." ... "the evidence advanced by the petitioners has fallen far short of demonstrating ... a link."'

The courts are evaluating methods and conclusions, not doing the actual research. They don't have to have medical degrees or be doctors, just understand enough science to comprehend the scientific method and enough math to follow the statistics.
This follows the same argument that one shouldn't have to be a doctor to take medicines correctly, or have to be a lawyer to follow any given law.

If there is a judicial proceeding that hinges on a scientific question, what else are you going to do?

This wasn't some stupid "And now, we will have a judge decide some science for us!" thing. A bunch of parties sued, alleging that their children had been harmed by vaccines. The only way that those cases could be decided, is by deciding whether or not the vaccines were indeed responsible. The court doesn't "decide scientific fact", it has scientific expert witnesses and research as evidence in deciding whether or not a particular party is responsible for a particular injury. The same way that a court would use eyewitness testimony or DNA forensic evidence.

Concerning scientific matters, judges rely on expert testimony. In this particular case, they relied on three experts appointed by the court that there was very little evidence to support a link between MMR vaccines and autism.

The vaccine court was set up by Congress as part of what is known as the National Vaccine Injury Compensation Program. It was primarily designed to compensate the tiny fraction of people who suffer serious side effects from vaccines. Rather than have these victims sue vaccine makers in regular court -- potentially putting the manufacturers out of business and jeopardizing a major component of the country's public health infrastructure -- the court set up a "no-fault" system that required victims to prove to a special master only that vaccines harmed them, and not that anyone intentionally caused the harm.

The reason that vaccines are mandated is very simple, herd immunity. Herd immunity is what lets people that can't get the vaccines (like your friend who is allergic) live their life without serious fear of catching these deadly diseases. Yes, vaccines carry some non-trivial amount of danger, but science has verified that the danger to the individual is outweighed by the danger of society losing herd immunity.

What people don't realize is that it only takes 10-15% of the population being unvaccinated to cause a major outbreak. Once that happens, it is much more likely for a disease to mutate and be able to attack even those that are vaccinated. That's why the government mandates vaccines, and since the government is mandating vaccines. It makes sense for the government to pay out when vaccines hurt people when the government is the one that made the decision, not the manufacturers.

This is why I hesitate to let "experts" force major social projects on us.

Agreed. We're much better off listening to Jenny freakin' McCarthy.

What happens if and when 20 years from now there is serious evidence of a link between autism and some vaccines.

"Smallpox was the first disease [wikipedia.org] people tried to prevent by purposely inoculating themselves with other types of infections; smallpox inoculation was started in China or India before 200 BC." Furthermore [wikipedia.org], in the UK "[v]accination was first made compulsory in 1853, and the provisions were made more stringent in 1867, 1871, and 1874."

We started the scientific experiment over 2,000 years ago and the social experiment over 150 years ago. I think we've got a pretty good handle on the statistics by now.

Take DNA for example. The courts have generally accepted that DNA is a unique identifier and that there are equipment out there that can determine if one sample of DNA matches another. Furthermore, the courts have accepted statistical data on the uniqueness of the DNA sample.

The question on whether the DNA evidence was collected and analyzed properly is typically a case by case issue.

Mr Wakefield received funding to see if there was any evidence to support possible legal action by a group of parents who claimed their children were damaged by the vaccine. Some children were involved in both studies.

If that wasn't bad enough, alongside with other charges (see
here [bbc.co.uk]), there are signs of him fixing the data [timesonline.co.uk] in the study. Not exactly what I'd call a pillar of ethical and unbiased behavior...

What happens if and when 20 years from now there is serious evidence of a link between autism and some vaccines. The people who mandated them will say "sorry we didn't know," but the parents should be able to say to them "fuck you, you will pay horrifically for what you did to our kids, you miserable social engineers."

I'm pretty certain the the plagues we'd suffer in the meantime through lack of vaccine uptake would deal with any sceptics nicely.

Not at all. It's a combination of 2 things:1. the definition of autism has broadened with time so that things that weren't considered autism 50 years ago now count2. better detection means people with autism are more likely to get counted.

The scientific consensus is that there is no reason to believe that autism is more common now than before.

You are correct, a judge is not an expert (unless he happens to have been a scientist in the field, not likely). But the judge did look at medical experts testimony and apparantly none of them are saying it is the fault of vaccines...that should mean something. The judge has access to qualified people - he is regurgitating their expert testimony and turning that into judicial law/precedent with his ruling that concurs with them.

But at the same time, courts don't have to make their rulings based on any sense of 'truth'. They don't even have to make them based on best scientific research, and there are many historical cases where they haven't. In Michael Shermer's book "The Borderlands Of Science" he talks about the widespread belief in the 1920's-1950's that local injury caused cancer. While there may be a relationship between injury repair and apperance of cancer, it's pretty weak, but in the '30's people regularly sued their employers for getting hit in the ankle and later developing cancer in the other foot -- and they won. In some cases, the courts even went so far as to say that despite there being no scientific evidence to support these claims, because it was a generally held belief that there was a relationship, they decided in favor of the injured worker.So, as I said, I *like* the court's decision, but I don't delude myself that they're Correct. They're just making a decision based on what has influenced the judges the most, and we can all hope that the decision turns out to be a good one.

FYI, the genetic bases for both of these trends is (at least partially) known. For Down's syndrome, this is caused by non-disjunction of chromosome 21. Since eggs are in a state of suspension in a female (after all having been created at the same time), the longer they are in this suspended state, the higher the chance for a non-disjunction. This also contributes to why miscarriage rates go up (and fertility down) as women age.

For autism, at least one of the contributing factors is de novo copy number variants (segment of the genome that have been deleted or duplicated). As the father gets older, his sperm (which he constantly makes) have undergone more copying, and mutations (errors in that copying) will accrue. Errors such as non-disjunctions, in which a whole chromosome is copied, lead to inviable sperm. However, smaller mutations are viable...but may still be deleterious.

A good doctor should welcome a parent who has done this research and isn't rejecting immunizations out of hand, but just the traditional schedule of how they are admitted, which many doctors have just taken a schedule from somebody else without doing any work to develop one on their own.

Doctors don't usually come up with their own schedules; unless you're actually an immunologist, it makes far more sense to trust a published schedule, like ACIP or NACI. These are reviewed every year, and cover all the interesting rules and interactions between various agents. Vaccination scheduling is far more complex than you might realize - there are specific rules covering live and non-live agents, which agents can be given at the same time, minimum/maximum intervals between series doses, and more.

Disclaimer: I've worked in the industry, specifically with regard to writing schedulers. I know firsthand how hard it is.

"It is worth noting the standard the court was using allowed for the petitioners (the parents of the children with autism) to demonstrate âoebiologic plausibilityâ as opposed to direct cause and effect. Scientifically, biological plausibility is an easier standard to meet."

So the courts ruled that it is not even plausible that the vaccines caused autism.

Of course one day there might be a theory and some evidence that changes this ruling.

No, it's best to do them early. When they're not done we see outbreaks quite quickly. This anti-vaccination movement has already led to several outbreaks of previously controlled diseases. The CDC publishes stats on this stuff. It's pretty easy for even a layman to follow.

I agree that kids probably don't need HPV at birth, but no one's advocating that. Even though Hepatitis-B, although most commonly transferred sexually or intravenously, is also often transferred among family members.

I think you're advocating for exactly what we already have. An expert board that constantly reviews what diseases we have vaccines for and when we should vaccinate for them. I don't think we should have a popular vote of parents or doctors deciding when they are scheduled.

The reason you vaccinate at 2-6 months is that the mothers antibodies provide protection up until then. After about 6 months the childs immune system is essentially on it's own. If it has seen a disease (or vaccine) prior to then they can safetly develope a native immunity to it while still under the umbrella of the mothers immune protection.

Today it is rare for a baby to die. 300 years ago it was assumed that most would die before the age of 5. The primary difference is vaccines. By vaccinating children you protect the child AND you reduce the disease load on the population in general.

I am very pleased that your gamble didn't hurt your children but if enough children are not vaccinated then the rate of these disease will shoot up dramatically, and these are deadly and debilitating diseases.

What else could they do? It's their job to determine if so-n-so is legally liable for this-n-that. This isn't necessarily a scientific statement that the vaccine doesn't cause autism (though the decision is based on such statements), but is a legal statement that if you blame autism on the vaccine, the government isn't going to be on your side. And making such statements is what the court is for.

Not at all. It's a combination of 2 things:
1. the definition of autism has broadened with time so that things that weren't considered autism 50 years ago now count
2. better detection means people with autism are more likely to get counted.

The scientific consensus is that there is no reason to believe that autism is more common now than before

Wrong! It is pretty clear that autism is more common than before and it seems to be something in the environment, but we do not know what, from Scientific American:

The California researchers concluded that doctors are diagnosing autism at a younger age because of increased awareness. But that change is responsible for only about a 24 percent increase in children reported to be autistic by the age "A shift toward younger age at diagnosis was clear but not huge," the report says. Also, a shift in doctors diagnosing milder cases explains another 56 percent increase. And changes in state reporting of the disorder could account for around a 120 percent increase. Combined, Hertz-Picciotto said those factors "don't get us close" to the 600 to 700 percent increase in diagnosed cases.

They stopped using thimerosal in the MMR vaccine *years* ago. In fact, that is what makes it so trivially easy to show that mercury from thimerosal in the MMR vaccine was unrelated to autism. They removed it, and nothing changed.

(And by nothing, I mean not even the anti-vaccination rhetoric. It's about as bad as the buffoons who claim that Coke is addictive because they surreptitiously still add cocaine -- undetectable cocaine, even!)

First, nobody knows the underlying causes of autism. One of the exacerbating circumstances with this issue is that autism is a "spectrum disorder" -- there are probably multiple causes, and no particular treatment will work across the board.

Second, vaccines are tested much the same as any other medication -- a population is selected, (assuming a double blind study) some of the population is given the actual medication while the remainder is given a placebo, statistical methods are then applied to determine the safety level. While this method validates (or invalidates) the safety of any particular medication, it says nothing about the safety of medical cocktails. Young children (less than 2 years old) are often given multiple vaccinations during a single "well" visit. Nobody has even attempted to determine if these multiple, simultaneous vaccinations are safe.

Third, and to the point, there is scientific evidence that the rate of autism is more common now than in the past. Scientific heresy you say? Consider this: In 1975 a study was performed to look at bleeding during pregnancy as a risk factor for autism and childhood psychosis. Computerized records of 30,000 children born between 1959 and 1965 at 14 university-affiliated medical centers were examined (that is a huge sample). Fourteen children were identified as having autism (by the definition used in 1975) -- a rate of 4.7 children per 10,000. This rate matched perfectly with other contemporary studies. Additionally, 6 other children were labeled as disturbed, psychotic, autistic, or schizophrenic. The remaining children were considered cognitively normal. Labeling all the cognitively non-normal children as autistic gives a rate of 6.7 children per 10,000. This rate is _far_, _far_ below even the low-end estimate of 30 per 10,000 for autistic spectrum disorders today cited by the National Institute of Health. FYI, the study was published in the highly credible Journal of autism and Childhood Schizophrenia in 1975. This is an apples-to-apples comparison folks. The rate of childhood autism is definitely increasing.

Finally, the court can make any ruling it wants. That in no way determines the cause or treatment of autism or any other disease for that matter. What is does do is throw yet another monkey wrench into the lives of families that are already struggling to deal with their situations. Our tax dollars would be better spent on medical research to identify the true causes of diseases and effective treatments.

Vaccine damages are paid to those whose own genetics have created a situation where (in this case vaccines) an outside agent cause an adverse reaction.
The vaccination payout fund is a way to keep the population immunized, knowing some people have a problem with vaccines.
It is politics, not science.

if vaccines actually work.. then why is it that the people who take them get all freaked out when you tell them you don't.

Because as the percentage of people who don't get their children vaccinated grows, the likelihood of an outbreak increases greatly, as well as the chance of mutation which could render the vaccine ineffective.

They -do- work. They're necessary, unless you like the thought of easily preventable diseases ripping through schools full of young children, far more of whom will die of the disease than are suspected of having been afflicted with autism because of them.

While it's looking more and more like autism isn't caused by the MMR vaccine it does seem that something that is integral to our modern way of life does cause it. Before I saw Rain Man I had never heard of Autism, now I have an autistic son, my ex has another autistic son, one of my best childhood friends has an autistic son, my GF has a son with asperger's, and there are others I am aware of within my community. This can't be explained by increased diagnosis and I didn't meet any of these people as a result of the condition. There is something that has entered our environment within the past half century or so that is causing an alarming rise in the incidence of autistic spectrum disorders. I don't know what it is, perhaps it's the foam padding in our furniture, or household cleaners, or chlorinated water supplies, or TV, or microwaves, or food additives. Perhaps it is vaccines and the pharmaceutical corporations are covering it up. I simply don't know.

Normally, after "in other words", one writes a summary of what he's responding to, literally restating the same point in other words.

What you've done, however, is write "in other words" followed by something completely different from what the parent said. Nice try, but you're doing it wrong.

The parent's point regarding herd immunity was that vaccination works not only for the person who gets vaccinated, but also for other members of the community who don't get vaccinated. If you choose not to vaccinate your child, you're not only making it more likely that he'll get sick, you're also making it more likely that all the other kids who aren't vaccinated will get sick.

if the kid is autistic enough to warrant being kicked out of school for autistim-related disrupions wouldn't that be easy enough for a doctor to detect early on?

No. Autistic children typically behave very differently in a one-on-one environment than they do in a group, between strangers and people they know, and also between an adult and their peers. Their behaviors are also not consistent, they may be fine in school 99% of the time, but then something will set them off that they can't deal with.

I don't know what's more frightening, your willful ignorance or the fact that someone modded it insightful.

By your logic, airbags don't work because they don't work 100% of the time in all circumstances. Or plants don't grow anywhere at all because they won't grow in battery acid.

As long as a large enough portion of a population is vaccinated against known strains there won't be enough hosts for a new strain to emerge that the vaccine is ineffective against.

Even people who were vaccinated can get it if there immune system has been compromised by something else. If most of the population is vaccinated the chance of being exposed to it while you have a compromised immune system is low. If the population was made up of ignorant fools, there'd be a good chance of coming into contact with it while you have a compromised immune system. Now there's a chance for a strain to develop that can handle the antibodies of someone who has had the vaccine. Then you give it to your kids, they spread it to the school, and so on until it's an epidemic.

Please, for the love of whatever invisible space man you believe in, don't breed. If you have, your invisible space man god told me to tell you to sacrifice them to him. Then they can play in space with the invisible pink unicorns.

You do realize that different compounds of Mercury have different chemical properties, right? Sure, some are dangerous in small amounts, but not all of them.

By your reasoning, since hydrogen is a toxin, then so is water.

Also, you might be surprised at the resolution of current statistical methods, even with relatively small sample sizes. It's very possible that an increase of 0.006% is detectable depending on the quality and size of the sample and the methods used.

I think it's horrible that the FDA told manufacturers to stop using a particular preservative not based on evidence that it was dangerous, but instead because a small group of vocal and misguided parents complained about it. It was stupid and, of course, seen as an admission that there was something wrong with it (when there's no evidence at all that there is).

Yes thank them, but they should still be giving the polio vaccine, so don't thank the cdc. One 3rd world country carrier could bring it back to the US and we are once again sitting ducks since none of the current generation are vaccinated.

Polio has been eradicated in the entire Western Hemisphere. I know that there are 3rd world countries outside of the western hemisphere, however the only 3rd world countries that have polio still are outside of the western hemisphere.

Since legal immigrants are required to get polio vaccines if they're from a location that still hasn't eradicated polio, we are left only with illegal immigrants. 50% of undocumented aliens arrived on a legal visa, that means they had their polio vaccination if necessary. So, we're left with some 50% or illegal immigrants all of which had to have arrived without a valid visa. The likelihood of them being outside of the western hemisphere is pretty low.

A good example is Rabies in Japan. The likelihood that an animal will enter the respective country with the respective disease without having the respective vaccine is super low.

The FDA banned aspertame, then Reagan stacked the deck and they lifted the ban. So the FDA is not some miracle organization immunite to politics and purchases. The nefarious piece I was refering to was the Merck lobbyist relationship with Gov Rick Perry and his push (and subsequent back down) to make it a mandatory vaccination. Even one of the researchers that was responsible says the mandatory says its a bad idea [fwdailynews1.com] that could increase the problem rather than decrease. You might also notice that this researcher is a university employee, not a direct employee of Merck. However, at $360 for the vaccination, you have a lot of room to grease some palms and still make a killer profit.

If you read up on the history, most of research on the best stuff is coming out of universities and non-profit driven organizations to include the MMR vaccination. I fail to see how questioning the big pharma companies that sell the stuff is a denial of its usefulness or effectiveness. The key piece that was under fire was the mercury content. Now, you can tell me all day long that it has been tested and tested at X% and it is safe, but I can point out more cases across a wide variety of industries where cost cutting and lack of QA led an otherwise safe product to become dangerous. Antibiotics is a whole other ball of wax and if you really want to talk about overprescription of antibiotics and the joys it has brought like drug resistant strains then that is fine. Antibiotics are great until you overuse them and build super strains. Now, aside from the culture of "right here right now" who would push increased use of antibiotics in cases where it really isn't needed?

I can't tell if people are really this dumb, or are deliberately misreading my comments on things like Cancer/AIDS. Cancer/AIDS is a damned difficult beast, and you can also join the ranks of the Capt. Obvious folks that keep pointing it out to me. If things like that weren't so damned hard to beat then companies would be doing the research because the cost of R&D would be more likely to be recouped. The fact is that truckloads of money have been spent on it and we still don't have a cure, big corp drug companies aren't going to waste dollars on that, they are going to use those dollars on something that is likely to have a return. This isn't evil corporate bosses, this is simple economics. The scientists that are lining up to tackle the monster problems are doing it in places without a profit motivation for operating. UCLA has some pretty promising stem cell tricks to fight AIDS.

I can attest to that as I am myself deaf in my right ear, and partly deaf in my left ear. There was a period in my youth when I was evaluated at length by by doctors who thought I may have a mild case of Asperger's Syndrome over and above my hearing difficulty, however, the diagnosis did not prove conclusive with enough evidence. I suspect at times they may have been right, but, the circumstances and lack of clinical research at the time was not enough (bare in mind I live in a so called "third world" country). As for specialised services, my primary school sent me in for a series of test, of which I passed with flying colours and was able to cope with regular schooling with relatively no difficulty. I am thankful for that, I probably would not be where I am were I sent to a specialised school. That being said, there was many occasions when I have been treated as a "retard", simply because I could not hear what was being said. In most cases I have to bring forth my hearing difficulty, to explain why I could not hear, and in most cases people take that into consideration when communicating with me without being overly sensitive. I've also had to undergo speech therapy, which really helped me a bit. Over the years I found ways to disguise my disability with the effect that most people I meet these days are absolutely clueless they are dealing with a deaf person:)